Family Planning Copayments

HFS System Issue:

Copayments may be taken incorrectly for office visits when billed for Family Planning Services.

Problem:

Family Planning Services are exempt from cost sharing. However, programming is not in place to prevent a copayment from being taken from reimbursement for office visits that indicate a Family Medical Service was provided by use of a diagnosis code in the V25 series.

Providers Impacted:

Physicians, Advance Practice Nurses, Federally Qualified Health Centers (FQHC), and Rural Health Clinics (RHC), Local Health Departments (LHD)

Procedure Codes Impacted:

E/M Codes

Problem Begin Date:

October 1, 2014

Problem Fix Date:

To be announced.

Resolution for Impacted Claims:

To be announced. Please continue to access this site for updated announcements.


Claims Processing System Issues

 

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